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Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer
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Atsushi Goto, Takeshi Okamoto, Ryo Ogawa, Kouichi Hamabe, Shinichi Hashimoto, Jun Nishikawa, Taro Takami
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Clin Endosc 2022;55(4):520-524. Published online July 28, 2022
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DOI: https://doi.org/10.5946/ce.2021.262
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 Abstract
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- Background
/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety.
Methods
Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment.
Results
Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed.
Conclusions
Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis Clinical trial number (UMIN000037567).
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Citations
Citations to this article as recorded by  - Predictors of stricture after endoscopic submucosal dissection of the esophagus and steroids application
Qing-Xia Wang, Yuan Ding, Qi-Liu Qian, Yin-Nan Zhu, Rui-Hua Shi
World Journal of Gastrointestinal Endoscopy.2024; 16(9): 509. CrossRef - Development of applicator to deliver hydrogel precursor powder for esophageal stricture prevention after endoscopic submucosal dissection
Takeshi Fujiyabu, Pan Qi, Kenichi Yoshie, Ayano Fujisawa, Yosuke Tsuji, Arvind Kumar Singh Chandel, Athira Sreedevi Madhavikutty, Natsuko F. Inagaki, Seiichi Ohta, Mitsuhiro Fujishiro, Taichi Ito
Chemical Engineering Journal.2024; 500: 156742. CrossRef
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Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure
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Hirofumi Harima, Kouichi Hamabe, Fusako Hisano, Yuko Matsuzaki, Tadahiko Itoh, Kazutoshi Sanuki, Isao Sakaida
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Clin Endosc 2018;51(6):596-599. Published online May 23, 2018
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DOI: https://doi.org/10.5946/ce.2018.057
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Abstract
PDFSupplementary MaterialPubReaderePub
- An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.
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